Panchenko O. Radiodiagnostics diagnostics of the close chest trauma. - Manuscript.

The dissertation is devoted to the challenge of improvement of radiodiagnostics of thoracal imperforate injuries in adult victims. According to the results obtained it was established that the main types of imperforate traumatic injuries and were rib fractures (97,3%), pleura injuries (85,5%) - hemopneumothorax (60,6%), hemothorax (21,3%) and pneumothorax (18,1%), pulmonary contusion (53,6%). Combination of pulmonary contusion with the pleura injuries is observed in 76,3% cases. On the basis of experimental and clinicopathologic analyses roentgenologic indices of pulmonary contusion of mild, medium and severe degrees, which include roentgen semeiotic symptoms, area of injury and terms of involution of pathological changes, were developed. Roentgenologic signs of traumatic instability of thoracic cage were determined to be rib fractures along two or more lines with formation of costal valves, which shift paradoxically in functional roentgenograms. Respiratory distress- and bronchial obturation syndromes were referred to the early pulmonary-pleural complications occurring on the 1st day after the trauma. Posttraumatic pneumonia, posttraumatic pleurisy and clotted hemothorax were referred to the late ones, the manifestation terms of which vary from 2 to 30 days (on average 15±6.58 days). The most sensitive and accurate method for thoracal imperforate injuries was computer-assisted tomography (CT). Standard roentgenography remains the main method for diagnostics of rib fractures. CT is the main diagnostic approach for pulmonary and pleural injuries. Ultrasonography and CT are diagnostic methods for clotted hemothorax .